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I
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u
r
al
co
m
m
u
n
it
y
i
n
So
u
t
h
W
est
Ni
g
e
r
ia
f
o
u
n
d
t
h
at
ab
o
u
t
4
4
%
o
f
r
esp
o
n
d
en
ts
u
tili
ze
d
o
r
th
o
d
o
x
h
ea
lt
h
ca
r
e
f
ac
ilit
ie
s
in
O
g
u
n
State
w
h
e
n
ill.
T
h
e
ass
o
ciate
d
in
f
l
u
e
n
ce
s
o
n
th
is
p
o
o
r
u
tili
za
tio
n
o
f
h
ea
lt
h
ca
r
e
f
ac
ilit
ie
s
o
b
s
er
v
ed
w
er
e;
p
ast
ex
p
er
ien
ce
s
w
it
h
h
ea
lt
h
s
er
v
ice
s
,
p
er
ce
p
tio
n
ab
o
u
t
th
e
q
u
alit
y
a
n
d
ef
f
icien
c
y
o
f
h
ea
lt
h
ca
r
e
s
er
v
i
ce
s
.
On
ce
a
n
in
d
i
v
id
u
al
i
s
ill,
h
e
ass
u
m
es
a
s
ick
r
o
le
an
d
is
ex
p
ec
ted
to
s
ee
k
th
e
s
er
v
ices
o
f
h
ea
lt
h
p
r
o
v
id
er
s
an
d
at
th
e
s
a
m
e
ti
m
e
co
o
p
er
ate
w
it
h
m
ed
ical
ad
v
ic
e
an
d
ex
p
er
tis
e
f
o
r
co
m
p
lete
e
x
p
lo
itatio
n
o
f
g
o
o
d
h
ea
lt
h
.
Su
r
p
r
is
i
n
g
l
y
,
t
h
is
i
s
n
o
t
s
o
as
m
o
s
t
i
n
d
iv
id
u
als
eit
h
er
d
elay
i
n
s
ee
k
i
n
g
p
r
o
m
p
t
o
r
th
o
d
o
x
m
ed
ical
ca
r
e
o
r
p
r
ef
er
th
e
u
s
e
o
f
tr
ad
itio
n
a
l
ap
p
r
o
ac
h
es
w
h
ic
h
n
e
g
ati
v
el
y
af
f
ec
t
s
t
h
e
o
v
er
all
o
u
tco
m
e
o
f
th
eir
il
ln
e
s
s
[
6
]
.
A
cc
o
r
d
in
g
to
Katu
n
g
[
7
]
an
d
Am
a
g
h
io
n
y
ed
i
w
e
[
8
]
,
th
e
d
ec
is
io
n
to
s
ee
k
h
elp
a
n
d
w
h
er
e
th
e
h
elp
w
i
ll
co
m
e
fr
o
m
i
n
r
elatio
n
to
h
ea
lt
h
is
i
n
f
lu
e
n
ce
d
b
y
s
o
m
an
y
f
ac
to
r
s
s
u
c
h
as;
i
n
d
i
v
id
u
al
‟
s
ed
u
ca
ti
o
n
al
an
d
ec
o
n
o
m
ic
s
tatu
s
,
s
e
v
er
it
y
o
f
t
h
e
s
y
m
p
t
o
m
s
o
f
ill
n
ess
,
s
o
cio
cu
lt
u
r
al
in
f
lu
e
n
ce
s
,
d
i
s
tan
ce
,
a
n
d
q
u
a
lit
y
o
f
h
ea
lth
ca
r
e
f
ac
ilit
ies,
co
s
t
o
f
tr
ea
t
m
en
t,
in
d
iv
id
u
al
‟
s
in
co
m
e,
ex
ten
t
to
w
h
ic
h
th
e
in
d
i
v
id
u
al
is
w
o
r
r
ied
ab
o
u
t
th
e
s
y
m
p
to
m
s
an
d
d
u
r
atio
n
o
f
ex
p
er
ien
cin
g
th
e
s
y
m
p
to
m
s
.
I
t
is
clea
r
th
at
in
d
iv
id
u
als
d
i
f
f
er
in
th
eir
w
illi
n
g
n
e
s
s
to
s
ee
k
h
elp
f
r
o
m
h
ea
lt
h
ca
r
e
s
er
v
ices.
W
h
ile
s
o
m
e
m
a
y
g
o
r
ea
d
il
y
f
o
r
tr
ea
t
m
e
n
t,
o
th
er
s
w
il
l
d
o
s
o
o
n
l
y
w
h
e
n
i
n
p
ain
s
a
n
d
ad
v
an
ce
d
s
tate
o
f
ill
h
ea
lt
h
.
T
h
e
ch
o
ice
o
f
t
h
e
h
ea
l
th
ca
r
e
p
r
o
v
id
er
co
n
s
u
lted
f
o
r
a
s
y
m
p
to
m
is
al
s
o
lin
k
ed
to
th
e
p
er
ce
iv
ed
ca
u
s
e
o
f
s
y
m
p
to
m
[
6
]
.
Yo
u
n
g
p
eo
p
le
h
av
e
s
p
ec
i
f
ic
h
ea
lt
h
p
r
o
b
lem
s
an
d
d
ev
elo
p
m
en
tal
n
ee
d
s
t
h
at
d
if
f
er
f
r
o
m
th
o
s
e
o
f
ch
ild
r
en
an
d
ad
u
lt.
T
h
e
ca
u
s
e
s
o
f
ill
h
ea
lt
h
in
ad
o
lesce
n
ts
a
r
e
m
o
s
t
l
y
p
s
y
ch
o
s
o
cial
r
at
h
er
th
an
b
io
lo
g
ical
[
9
]
.
Yo
u
n
g
p
eo
p
le
o
f
ten
en
g
a
g
e
i
n
h
ea
lt
h
r
i
s
k
b
eh
a
v
io
u
r
s
t
h
at
r
ef
lect
t
h
e
p
r
o
ce
s
s
es
o
f
ad
o
le
s
ce
n
t
d
ev
elo
p
m
e
n
t
:
ex
p
er
i
m
e
n
tatio
n
a
n
d
ex
p
lo
r
atio
n
,
in
cl
u
d
in
g
u
s
in
g
d
r
u
g
s
an
d
alco
h
o
l,
s
ex
u
al
b
eh
a
v
io
u
r
[
1
0
]
.
Ho
w
e
v
er
,
s
ee
k
i
n
g
h
ea
lt
h
h
elp
w
h
e
n
s
ick
b
y
t
h
e
s
e
y
o
u
n
g
p
eo
p
le
ca
n
b
e
a
p
r
o
b
le
m
a
s
h
av
e
b
ee
n
o
b
s
er
v
ed
i
n
co
lle
g
es
an
d
u
n
i
v
er
s
i
t
y
ca
m
p
u
s
e
s
.
A
cc
o
r
d
in
g
to
th
e
atte
n
d
an
ce
r
e
g
is
ter
o
f
t
h
e
m
ed
ical
ce
n
ter
,
Un
iv
er
s
it
y
o
f
Ni
g
er
ia
E
n
u
g
u
C
a
m
p
u
s
an
al
y
ze
d
b
y
th
e
r
ec
o
r
d
s
d
ep
ar
tm
e
n
t,
less
t
h
an
2
5
%
o
f
t
h
e
s
t
u
d
en
t
v
is
i
ted
th
e
cli
n
i
c
f
o
r
h
ea
lth
r
elate
d
is
s
u
e
in
a
m
o
n
t
h
an
d
t
h
e
s
t
u
d
e
n
ts
i
n
t
h
e
Facu
lt
y
o
f
Hea
lt
h
Sc
ien
ce
an
d
T
ec
h
n
o
lo
g
y
ar
e
th
e
least in
at
te
n
d
a
n
ce
.
I
n
o
r
d
er
to
s
ee
k
h
elp
,
s
tu
d
en
ts
m
u
s
t
b
eg
i
n
b
y
t
h
in
k
i
n
g
th
er
e
is
a
p
r
o
b
lem
r
eq
u
ir
in
g
p
r
o
f
ess
io
n
a
l
atten
tio
n
.
On
ce
a
s
tu
d
e
n
t
r
ea
ch
es
o
u
t
to
s
ee
k
h
elp
,
h
e/
s
h
e
m
u
s
t
d
ec
id
e
w
h
er
e
to
s
ee
k
h
elp
an
d
also
f
r
o
m
w
h
o
m
.
Fo
r
ex
a
m
p
le,
s
tu
d
e
n
ts
m
a
y
t
u
r
n
to
i
n
f
o
r
m
a
l
h
elp
s
o
u
r
ce
s
s
u
c
h
a
s
r
o
o
m
m
ates
an
d
f
r
ie
n
d
s
.
T
h
e
y
m
a
y
also
s
ee
k
a
s
s
i
s
ta
n
ce
f
r
o
m
f
o
r
m
al
h
elp
s
o
u
r
ce
s
s
u
c
h
a
s
co
u
n
s
elo
r
o
r
g
e
n
er
al
h
ea
lt
h
ce
n
ter
s
taf
f
.
W
h
en
s
t
u
d
en
ts
d
o
s
ee
k
h
elp
,
t
h
e
y
w
ill
co
n
t
in
u
e
to
m
ak
e
d
ec
is
io
n
s
ab
o
u
t
th
e
ex
te
n
t
to
w
h
ich
t
h
is
h
elp
is
s
till
n
ee
d
ed
.
Stu
d
e
n
ts
‟
ab
ilit
y
to
ca
r
r
y
o
u
t t
h
ese
h
elp
-
s
ee
k
i
n
g
b
eh
a
v
io
u
r
s
r
ests
o
n
a
m
u
l
tit
u
d
e
o
f
f
ac
to
r
s
.
T
h
eir
h
elp
-
s
ee
k
in
g
b
eh
av
io
u
r
s
also
d
ep
en
d
o
n
a
h
o
s
t
o
f
en
v
ir
o
n
m
en
ta
l
an
d
ca
m
p
u
s
-
r
elate
d
f
ac
to
r
s
,
in
cl
u
d
in
g
t
h
e
n
at
u
r
e
an
d
ex
ten
t
o
f
h
ea
l
th
s
u
p
p
o
r
ts
o
r
s
er
ies
av
ailab
le
o
n
ca
m
p
u
s
a
n
d
w
it
h
i
n
t
h
e
co
m
m
u
n
it
y
[
9
]
.
I
t
i
s
in
t
h
e
lig
h
t
o
f
t
h
e
f
o
r
eg
o
in
g
th
a
t
th
i
s
r
esear
ch
w
a
s
n
ec
es
s
itated
to
in
v
e
s
ti
g
at
e
v
ar
io
u
s
h
ea
l
th
s
s
ee
k
i
n
g
b
eh
av
o
u
r
s
ex
h
ib
ited
b
y
u
n
d
er
g
r
ad
u
ates i
n
th
e
Facu
l
t
y
o
f
Hea
lth
Scien
ce
a
n
d
T
ec
h
n
o
lo
g
y
i
n
th
e
ir
q
u
est to
b
e
h
ea
lt
h
y
.
2.
T
H
E
O
R
E
T
I
CA
L
RE
V
I
E
W
2
.
1
.
T
he
H
ea
lt
h B
elief
M
o
del (
H
B
M
)
T
h
e
Hea
lth
B
elie
f
Mo
d
el
d
ev
elo
p
ed
in
1
9
5
0
s
b
y
a
g
r
o
u
p
o
f
Am
er
ica
n
P
u
b
lic
Hea
lt
h
Ser
v
ice
So
cial
P
s
y
c
h
o
lo
g
i
s
ts
(
Ho
ch
b
a
u
m
,
R
o
s
en
s
to
ck
an
d
Ke
g
els)
p
r
o
v
id
es
ex
p
lan
at
io
n
s
o
n
t
h
e
w
a
y
s
p
eo
p
le
r
ea
ct
to
h
ea
lt
h
is
s
u
es.
T
h
e
m
o
d
el
s
ee
k
s
to
e
x
p
lain
w
h
y
f
e
w
p
eo
p
le
p
ar
ticip
ate
in
m
ea
s
u
r
es
to
p
r
ev
e
n
t
o
r
d
etec
t
d
is
ea
s
es
[
1
1
]
.
I
t p
r
o
p
o
s
es th
at
a
p
er
s
o
n
‟
s
h
ea
lth
r
elate
d
b
eh
av
io
u
r
d
ep
en
d
s
o
n
th
e
p
er
s
o
n
‟
s
p
er
ce
p
tio
n
o
f
s
ix
cr
itical
ar
ea
s
.
1.
T
h
e
s
ev
er
it
y
o
f
a
p
o
ten
tial
illn
e
s
s
(
p
er
ce
iv
ed
s
e
v
er
it
y
)
:
th
i
s
is
h
o
w
s
er
io
u
s
a
co
n
d
itio
n
a
n
d
it
s
co
n
s
eq
u
e
n
ce
s
ar
e.
I
t sp
ec
if
ie
s
co
n
s
eq
u
e
n
ce
s
o
f
t
h
e
r
is
k
an
d
t
h
e
co
n
d
itio
n
2.
T
h
e
p
er
s
o
n
‟
s
s
u
s
ce
p
tib
ilit
y
to
th
at
ill
n
e
s
s
(
p
er
ce
iv
ed
s
u
s
ce
p
t
ib
ilit
y
)
:
it
m
ea
n
s
o
n
e‟
s
o
p
in
io
n
o
f
c
h
a
n
ce
s
o
f
g
etti
n
g
a
co
n
d
it
io
n
.
De
f
in
e
s
p
o
p
u
latio
n
(
s
)
at
r
is
k
.
3.
T
h
e
b
en
ef
its
o
f
ta
k
in
g
an
ac
ti
o
n
(
p
er
ce
iv
ed
b
en
ef
its
)
:
it
m
e
an
s
o
n
e
‟
s
b
elie
f
in
t
h
e
ef
f
icac
y
o
f
th
e
ad
v
i
s
ed
ac
tio
n
to
r
ed
u
ce
r
is
k
o
r
s
er
io
u
s
n
e
s
s
o
f
i
m
p
ac
t.
4.
B
ar
r
ier
s
to
tak
i
n
g
t
h
e
ac
t
io
n
(
p
er
ce
iv
ed
b
ar
r
ier
s
)
:
it
e
n
tail
s
o
n
e
‟
s
o
p
in
io
n
o
f
t
h
e
tan
g
ib
le
a
n
d
p
s
y
ch
o
lo
g
ical
co
s
ts
o
f
th
e
ad
v
is
ed
ac
tio
n
.
5.
C
u
e
s
to
A
c
tio
n
: it
d
escr
ib
es
h
o
w
to
p
r
o
m
o
te
a
w
ar
en
e
s
s
a
n
d
d
is
s
e
m
in
ate
i
n
f
o
r
m
atio
n
.
6.
Self
-
e
f
f
icac
y
: i
t
m
ea
n
s
co
n
f
id
en
ce
in
o
n
e
‟
s
ab
ilit
y
to
ta
k
e
ac
tio
n.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
E
R
E
I
SS
N:
2252
-
8822
Hea
lth
S
ee
kin
g
B
e
h
a
vio
u
r
a
m
o
n
g
Un
d
erg
r
a
d
u
a
tes in
t
h
e
F
a
cu
lty
o
f
.
.
.
.
(
Oke
ch
u
kwu
Od
in
a
ka
A
ja
eg
b
u
)
1
83
T
h
u
s
,
th
e
m
o
d
el
s
u
g
g
e
s
ts
t
h
at
s
tu
d
e
n
ts
o
f
Fac
u
lt
y
o
f
Hea
l
t
h
Scie
n
ce
a
n
d
T
ec
h
n
o
lo
g
y
w
i
ll
s
ee
k
f
o
r
h
ea
lt
h
ca
r
e
i
f
t
h
e
u
n
d
er
s
ta
n
d
th
at
t
h
e
y
ca
n
b
e
s
ic
k
(
p
er
ce
iv
ed
s
u
s
ce
p
tib
ilit
y
)
a
n
d
th
at
m
ild
s
y
m
p
to
m
s
t
h
at
h
er
ald
s
t
h
e
o
n
s
et
o
f
ill
n
es
s
c
an
i
n
cr
ea
s
e
i
n
it
s
s
e
v
er
it
y
(
p
er
ce
iv
ed
s
ev
er
i
t
y
)
i
f
ap
p
r
o
p
r
iate
tr
ea
t
m
e
n
t
i
s
n
o
t
s
o
u
g
h
t.
I
f
in
d
i
v
id
u
al
s
d
o
n
o
t
s
ee
„
b
o
d
il
y
ch
a
n
g
es
‟
th
a
t
o
cc
u
r
d
u
r
in
g
ill
n
ess
a
s
th
r
ea
te
n
i
n
g
o
r
r
is
k
y
,
t
h
er
e
is
n
o
s
ti
m
u
l
u
s
to
ac
t.
T
o
ef
f
ec
ti
v
el
y
a
v
o
id
d
ela
y
s
in
s
ee
k
i
n
g
h
e
alth
ca
r
e
d
u
r
in
g
th
e
m
a
n
i
f
es
t
atio
n
o
f
s
i
g
n
s
an
d
s
y
m
p
to
m
s
,
th
e
i
n
d
iv
id
u
als
s
h
o
u
ld
h
a
v
e
t
h
e
ab
ilit
y
to
i
n
ter
p
r
et
th
ese
s
i
g
n
s
(
C
u
es
to
ac
tio
n
)
as
w
e
ll
as
u
n
d
er
s
ta
n
d
th
at
t
h
e
s
e
s
i
g
n
s
ca
n
p
r
o
g
r
ess
i
v
el
y
b
ec
o
m
e
s
ev
er
e
an
d
lead
to
a
s
tag
e
w
ith
w
o
r
s
e
p
r
o
g
n
o
s
is
.
Fu
r
t
h
er
m
o
r
e,
w
h
e
n
th
e
b
en
e
f
its
o
f
s
ee
k
i
n
g
p
r
o
m
p
t
h
ea
lt
h
ca
r
e
s
er
v
ice
o
u
t
w
ei
g
h
t
h
e
p
er
ce
iv
ed
b
ar
r
ier
s
to
tak
in
g
s
u
c
h
ac
tio
n
s
,
in
d
iv
id
u
als
w
i
ll
n
o
t
d
ela
y
b
ef
o
r
e
th
e
y
s
ee
k
g
o
o
d
p
r
o
f
ess
io
n
al
m
ed
ical
h
elp
.
So
m
e
p
er
ce
iv
ed
b
ar
r
ier
s
to
p
r
o
m
p
t
h
ea
lt
h
ca
r
e
s
ee
k
i
n
g
b
eh
av
io
u
r
i
n
cl
u
d
e;
p
er
ce
iv
ed
ca
u
s
e,
ac
ce
s
s
ib
ili
t
y
o
f
th
e
h
ea
lth
f
ac
i
liti
es,
d
u
r
atio
n
an
d
co
m
p
lex
i
t
y
o
f
t
h
e
tr
ea
t
m
en
t
p
r
o
ce
s
s
etc.
T
h
is
m
ea
n
s
t
h
at
a
s
t
u
d
en
t
w
ill
d
elay
i
n
s
ee
k
i
n
g
f
o
r
h
ea
lt
h
ca
r
e
s
er
v
ice
i
f
in
h
is
o
p
in
io
n
th
e
s
e
b
ar
r
ier
s
o
u
t
w
ei
g
h
t
h
e
g
a
in
.
3.
RE
S
E
ARCH
M
E
T
H
O
D
T
h
e
s
tu
d
y
w
a
s
co
n
d
u
cted
i
n
Un
i
v
er
s
it
y
o
f
Ni
g
er
ia,
E
n
u
g
u
C
a
m
p
u
s
(
UNE
C
)
.
T
h
is
ca
m
p
u
s
is
o
n
e
o
f
th
e
ca
m
p
u
s
e
s
o
f
t
h
e
p
r
esti
g
io
u
s
U
n
i
v
er
s
it
y
o
f
N
ig
er
ia.
I
t
h
as
s
i
x
f
ac
u
ltie
s
(
B
u
s
i
n
es
s
A
d
m
i
n
is
tr
atio
n
,
L
a
w
,
Me
d
ical
Scien
ce
s
,
De
n
ti
s
tr
y
,
E
n
v
ir
o
n
m
e
n
tal
Scie
n
ce
s
,
Hea
l
th
Sc
ien
c
e
s
a
n
d
T
ec
h
n
o
lo
g
y
)
w
it
h
a
p
o
p
u
latio
n
o
f
ab
o
u
t
5
8
7
8
u
n
d
er
g
r
ad
u
ates.
F
ac
u
lt
y
o
f
Hea
lth
Scie
n
ce
s
an
d
T
ec
h
n
o
lo
g
y
m
a
k
es
u
p
ab
o
u
t
2
6
.
2
%
o
f
th
e
to
tal
ca
m
p
u
s
p
o
p
u
latio
n
tr
a
n
s
lat
in
g
to
1
5
2
9
s
tu
d
en
ts
.
I
t
h
a
s
f
o
u
r
d
ep
ar
tm
e
n
ts
i
n
cl
u
d
in
g
n
u
r
s
i
n
g
s
cie
n
ce
s
,
m
ed
ical
lab
o
r
ato
r
y
s
cie
n
ce
,
m
ed
ical
r
a
d
io
g
r
ap
h
y
an
d
m
ed
ical
r
eh
ab
il
itatio
n
.
A
d
e
s
cr
ip
tiv
e
s
u
r
v
e
y
r
esear
ch
d
esig
n
w
as
e
m
p
lo
y
ed
w
h
ile
q
u
esti
o
n
n
a
ir
e
w
as
d
ata
co
llecti
o
n
to
o
l
f
o
r
th
e
s
t
u
d
y
.
T
h
e
p
o
p
u
latio
n
o
f
t
h
is
s
tu
d
y
in
c
lu
d
es
al
l
s
t
u
d
en
t
s
f
r
o
m
2
0
0
-
5
0
0
lev
el
in
t
h
e
Fa
cu
lt
y
.
T
h
e
1
0
0
lev
el
o
f
th
i
s
f
ac
u
lt
y
ar
e
ex
c
lu
d
ed
i
n
th
i
s
s
t
u
d
y
b
ec
au
s
e
th
e
y
ar
e
n
o
t
p
r
esen
t
in
t
h
e
ca
m
p
u
s
(
t
h
e
y
ar
e
in
N
s
u
k
k
a
ca
m
p
u
s
)
.
A
cc
o
r
d
in
g
to
th
e
s
t
u
d
en
t
af
f
air
s
UNE
C
R
ec
o
r
d
s
d
ep
ar
tm
e
n
t
o
f
2
0
1
4
/2
0
1
5
ac
a
d
e
m
ic
y
ea
r
,
th
e
to
tal
p
o
p
u
latio
n
o
f
u
n
d
er
g
r
ad
u
ate
s
(
2
0
0
–
5
0
0
lev
els)
in
Fac
u
lt
y
o
f
Hea
lt
h
Scie
n
ce
an
d
T
ec
h
n
o
l
o
g
y
is
1
5
2
9
.
T
h
e
s
a
m
p
le
s
ize
f
o
r
t
h
is
s
tu
d
y
is
3
1
7
an
d
w
as d
eter
m
i
n
ed
u
s
i
n
g
T
ar
o
Yam
a
n
e
f
o
r
m
u
lae
n
s
=
n
×
W
h
er
e
n
s
=
s
a
m
p
le
p
o
p
u
latio
n
f
r
o
m
e
ac
h
d
ep
ar
t
m
en
t
Ns=
m
ea
n
s
p
o
p
u
latio
n
o
f
ea
ch
d
ep
ar
t
m
e
n
t
n
=
to
tal
s
a
m
p
le
s
ize
=
3
1
7
N=
to
tal
p
o
p
u
latio
n
=
1
5
2
9
B
ef
o
r
e
th
e
ac
tu
al
d
is
tr
ib
u
tio
n
o
f
th
e
q
u
es
tio
n
n
air
es,
a
p
ilo
t
s
u
r
v
e
y
w
as
co
n
d
u
cted
u
s
i
n
g
t
w
e
n
t
y
(
2
0
)
co
p
ies
o
f
th
e
q
u
est
io
n
n
air
es
d
i
s
tr
ib
u
ted
to
s
elec
ted
s
t
u
d
en
ts
i
n
th
e
Fac
u
lt
y
o
f
Hea
l
th
Sc
ien
c
e
an
d
T
ec
h
n
o
lo
g
y
,
E
n
u
g
u
State
Un
i
v
er
s
i
t
y
o
f
T
ec
h
n
o
lo
g
y
.
R
e
s
u
l
ts
o
b
tain
ed
in
d
icate
d
th
at
in
s
tr
u
m
e
n
t
i
s
h
i
g
h
l
y
r
eliab
le
w
it
h
a
C
r
o
n
b
ac
h
‟
s
alp
h
a
co
ef
f
icien
t
as
0
.
7
5
2
.
T
h
is
co
ef
f
icien
t
b
ein
g
g
r
ea
ter
th
a
n
0
.
7
in
d
icate
s
th
a
t
t
h
e
tes
t
in
s
tr
u
m
en
t
i
s
h
i
g
h
l
y
r
eliab
le.
U
s
in
g
s
i
m
p
le
r
an
d
o
m
s
a
m
p
lin
g
m
et
h
o
d
,
th
e
r
esear
ch
er
s
id
en
ti
f
y
a
n
d
ad
m
i
n
i
s
ter
th
e
q
u
es
tio
n
n
air
e
to
3
1
7
r
es
p
o
n
d
en
ts
.
Data
co
llected
w
e
r
e
an
al
y
ze
d
u
s
i
n
g
s
i
m
p
le
d
e
s
cr
ip
tiv
e
s
ta
tis
t
ical
m
ea
s
u
r
es
w
h
ich
i
n
cl
u
d
e
f
r
eq
u
en
cie
s
an
d
p
er
ce
n
tag
e
s
.
T
h
e
an
al
y
s
is
w
as
d
o
n
e
u
s
in
g
Sta
tis
tical
P
ac
k
ag
e
f
o
r
So
cial
Scien
ce
s
(
SP
SS
)
v
er
s
io
n
2
0
s
o
f
t
w
ar
e.
Fin
all
y
e
th
ica
l a
p
p
r
o
v
al
o
b
tain
ed
f
r
o
m
t
h
e
Dea
n
o
f
s
tu
d
e
n
ts
‟
af
f
a
ir
s
,
UNE
C
w
a
s
f
u
ll
y
o
b
s
er
v
ed
.
Or
al
co
n
s
en
t
w
a
s
o
b
tain
ed
f
r
o
m
ea
ch
r
esp
o
n
d
en
t
b
ef
o
r
e
q
u
esti
o
n
n
air
e
ad
m
i
n
is
tr
atio
n
.
W
h
en
a
r
esp
o
n
d
en
t
ch
o
s
e
n
o
t to
p
ar
ticip
ate,
th
e
q
u
esti
o
n
n
air
e
w
as r
etu
r
n
ed
as a
r
ef
u
s
al
an
d
it
w
a
s
r
e
ad
m
in
is
ter
ed
.
4.
RE
SU
L
T
S
A
ND
AN
AL
Y
SI
S
T
ab
le
1
s
h
o
w
s
t
h
at
o
u
t
o
f
th
e
3
0
2
r
esp
o
n
d
en
ts
w
h
o
co
m
p
leted
th
e
q
u
e
s
tio
n
n
air
es
an
d
r
etu
r
n
ed
it,
1
6
2
s
tu
d
en
ts
w
er
e
m
ale
s
w
it
h
th
eir
m
ea
n
a
g
e
as 2
5
±
3
y
ea
r
s
w
h
er
ea
s
1
4
0
s
tu
d
e
n
ts
w
er
e
f
e
m
ales
w
it
h
m
ea
n
a
g
e
o
f
2
1
±
2
y
ea
r
s
.
I
t
w
a
s
also
s
h
o
w
n
th
at
2
8
2
s
tu
d
e
n
ts
(
9
3
.
4
%)
w
er
e
s
i
n
g
le
w
h
ile
2
0
s
tu
d
en
ts
(
6
.
6
%)
w
er
e
m
ar
r
ied
.
No
n
e
o
f
th
ese
s
t
u
d
en
ts
w
er
e
eith
er
w
id
o
w
s
/
w
id
o
w
er
s
n
o
r
d
iv
o
r
ce
d
.
2
9
5
(
9
7
.
7
%)
r
esp
o
n
d
en
ts
ac
k
n
o
w
led
g
ed
b
ein
g
C
h
r
is
tia
n
s
,
7
(
3
.
7
%)
w
er
e
Mu
s
li
m
s
a
n
d
n
o
n
e
o
f
t
h
e
s
t
u
d
en
t
s
w
er
e
Af
r
ican
T
r
ad
itio
n
al
w
o
r
s
h
ip
p
er
s
o
r
A
th
e
is
t
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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d
en
t
s
w
h
o
u
s
e
s
p
ir
itu
al
to
o
ls
b
elie
v
e
th
at
t
h
er
e
is
n
o
m
ed
ical
cu
r
e
f
o
r
th
eir
p
r
esen
t
s
y
m
p
to
m
s
an
d
th
at
it
is
m
o
r
e
ef
f
ec
ti
v
e
a
n
d
ac
ce
s
s
ib
le.
St
u
d
en
t
s
w
h
o
h
a
v
e
r
est
o
r
w
h
o
d
o
n
o
t
tak
e
ac
tio
n
s
r
elatin
g
to
h
ea
lt
h
w
h
e
n
s
ic
k
d
o
s
o
b
ec
au
s
e
th
e
y
f
ee
l
t
h
e
s
ic
k
n
e
s
s
i
s
n
o
t
li
f
e
t
h
r
ea
ten
in
g
a
n
d
ar
e
s
h
y
to
d
is
clo
s
e
t
h
e
s
y
m
p
to
m
s
to
an
y
o
n
e.
L
ac
k
o
f
k
n
o
w
led
g
e
o
n
w
h
er
e
to
s
ee
k
h
elp
is
th
e
least
f
ac
to
r
af
f
ec
ti
n
g
th
e
s
t
u
d
en
t
s
‟
c
h
o
ice
o
f
r
est
in
m
a
n
ag
i
n
g
s
y
m
p
to
m
s
.
T
h
ese
f
i
n
d
in
g
s
ar
e
in
lin
e
w
it
h
t
h
at
o
f
T
an
i
m
o
la
et
al
[
1
6
]
;
N
w
ac
h
u
k
w
u
[
1
5
]
an
d
B
a
b
atu
n
d
e
et
al
[
1
4
]
.
T
h
ey
r
e
v
e
aled
th
at
o
b
s
er
v
i
n
g
r
est
as
th
e
s
o
l
u
tio
n
to
i
lln
e
s
s
i
s
b
ec
au
s
e
s
y
m
p
to
m
s
ar
e
n
o
t
c
o
n
s
id
er
ed
li
f
e
t
h
r
ea
ten
i
n
g
.
Ho
w
e
v
er
,
t
h
e
lac
k
o
f
f
u
n
d
in
s
ee
k
i
n
g
o
r
th
o
d
o
x
ca
r
e
as
r
ev
ea
led
in
th
e
w
o
r
k
o
f
B
ab
atu
n
d
e
et
al
[
1
4
]
co
n
tr
ad
i
c
ts
th
at
w
h
ic
h
w
a
s
o
b
tain
ed
in
t
h
is
s
tu
d
y
.
T
h
e
p
o
s
s
ib
le
ex
p
la
n
atio
n
to
t
h
is
co
n
tr
ad
ictio
n
co
u
ld
b
e
b
ec
au
s
e
o
f
th
e
f
r
ee
m
ed
ical
s
er
v
ices o
b
tai
n
ab
le
at
th
e
h
ea
lt
h
ce
n
tr
e
i
n
th
is
C
a
m
p
u
s
.
6.
CO
NCLU
SI
O
N
Hea
lth
is
es
s
en
tial
f
o
r
s
o
cial
an
d
ec
o
n
o
m
ic
d
ev
elo
p
m
e
n
t
o
f
a
co
u
n
tr
y
.
Ho
w
ev
er
,
in
m
o
s
t
d
ev
elo
p
in
g
co
u
n
tr
ies
s
u
c
h
as
Ni
g
er
ia,
m
an
y
p
eo
p
le
esp
ec
iall
y
ch
i
ld
r
en
a
n
d
y
o
u
th
s
d
ie
ea
c
h
y
ea
r
o
u
t
o
f
p
r
ev
en
tab
le
ca
u
s
e
s
.
T
h
is
h
as
b
ee
n
at
tr
ib
u
t
ed
to
r
is
k
y
b
eh
a
v
io
u
r
s
e
n
g
ag
ed
b
y
y
o
u
t
h
s
t
h
at
ex
p
o
s
e
t
h
e
m
to
v
ar
io
u
s
h
ea
t
h
ch
alle
n
g
e
s
;
y
e
t
s
ee
k
in
g
h
ea
lth
h
elp
w
h
e
n
s
ic
k
b
y
t
h
ese
y
o
u
n
g
p
eo
p
le
ca
n
b
e
a
p
r
o
b
lem
.
T
h
is
s
tu
d
y
d
is
cu
s
s
ed
v
ar
io
u
s
h
ea
lt
h
-
s
ee
k
in
g
b
eh
a
v
o
u
r
s
e
x
h
ib
ited
b
y
u
n
d
er
g
r
ad
u
ates
i
n
th
e
Fac
u
lt
y
o
f
Hea
lth
Scie
n
ce
a
n
d
T
ec
h
n
o
lo
g
y
,
Un
i
v
er
s
i
t
y
o
f
Ni
g
er
ia,
E
n
u
g
u
C
a
m
p
u
s
.
T
h
e
s
tu
d
y
r
e
v
ea
led
t
h
at
s
t
u
d
en
ts
d
o
n
o
t
g
o
to
th
e
h
o
s
p
ital
u
n
t
il
th
e
y
ex
p
er
ie
n
ce
p
ain
s
t
h
at
th
e
y
ca
n
n
o
t
ac
co
m
m
o
d
ate
ag
ain
.
Ma
j
o
r
f
ac
to
r
s
af
f
ec
t
in
g
t
h
e
ch
o
ice
o
f
h
ea
l
th
ca
r
e
ad
o
p
ted
w
h
en
ill
i
s
m
o
s
t
l
y
r
elate
d
to
its
ac
ce
s
s
ib
ilit
y
,
ef
f
ec
tiv
e
n
e
s
s
a
n
d
n
o
n
e
d
ela
y
.
Fin
al
l
y
,
t
h
e
s
tu
d
y
r
ec
o
m
m
e
n
d
s
t
h
at
w
h
ile
Go
v
e
r
n
m
e
n
t
s
h
o
u
ld
li
v
e
u
p
to
its
r
esp
o
n
s
ib
ilit
y
o
f
p
r
o
v
id
in
g
ac
ce
s
s
to
h
ea
lt
h
ca
r
e
f
ac
ilit
ies,
h
ea
l
th
p
r
o
m
o
tio
n
a
n
d
p
r
ev
en
tiv
e
s
tr
ateg
ie
s
s
h
o
u
ld
b
e
r
ein
f
o
r
ce
d
in
Un
i
v
er
s
i
ties
.
RE
F
E
R
E
NC
E
S
[1
]
Un
it
e
d
Na
ti
o
n
s
Ch
il
d
re
n
F
u
n
d
(
UN
IC
EF
)
,
“
T
h
e
S
tate
o
f
th
e
W
o
rld
‟s
Ch
il
d
re
n
:
W
o
m
e
n
a
n
d
Ch
il
d
re
n
-
T
h
e
Do
u
b
le
Div
id
e
n
d
o
f
Ge
n
d
e
r
Eq
u
il
it
y
,”
Ne
w
Yo
rk
,
M
iff
li
n
P
u
b
l
ish
e
rs
,
2
0
1
0
.
[2
]
W
o
rld
He
a
lt
h
Org
a
n
iza
ti
o
n
(W
H
O)
,
“
G
lo
b
a
l
S
trate
g
y
f
o
r
He
a
lt
h
S
y
st
e
m
A
p
p
ra
isa
l:
He
a
lt
h
f
o
r
A
ll
in
2
0
2
0
,”
2
0
1
0
.
Re
tri
e
v
e
d
f
ro
m
h
tt
p
//
ww
w
.
w
h
o
.
in
t
in
2
0
th
A
u
g
u
st,
2
0
1
4
.
[3
]
De
m
o
g
ra
p
h
ic
He
a
lt
h
S
u
rv
e
y
(DH
S
)
,
“
M
e
a
su
re
DH
S
sta
t
-
c
o
m
p
il
e
r
d
a
tab
a
se
,”
2
0
1
2
.
Re
tri
e
v
e
d
f
ro
m
h
tt
p
:
//
ww
w
.
sta
tco
m
p
il
e
r.
c
o
m
27
th
Oc
to
b
e
r,
2
0
1
4
.
[4
]
M.
A
d
e
y
e
m
o
,
A
.
Olu
wa
to
sin
,
T
.
Ye
k
in
n
i
,
“
Ho
m
e
M
a
n
a
g
e
m
e
n
t
a
n
d
p
re
v
e
n
ti
o
n
o
f
m
a
laria
a
m
o
n
g
u
n
d
e
r
-
f
iv
e
c
h
il
d
re
n
:
Ex
p
e
rien
c
e
s
o
f
m
o
th
e
rs
in
Eg
b
e
d
o
re
L
o
c
a
l
G
o
v
e
rn
m
e
n
t
A
re
a
,
Os
u
n
S
tate
Nig
e
ria
,”
Af
ric
a
n
J
o
u
rn
a
l
o
f
Bi
o
me
d
ica
l
Res
e
a
rc
h
,
v
o
l/
issu
e
:
1
7
(2
)
,
p
p
.
2
7
1
-
2
8
1
,
2
0
1
4
.
[5
]
S.
S
u
le,
K.
Ijad
u
n
o
la,
A
.
On
a
y
a
d
e
,
e
t
a
l.
,
“
A
stu
d
y
o
n
th
e
Util
iza
ti
o
n
o
f
P
HC
F
a
c
il
it
ies
in
a
Ru
r
a
l
Co
m
m
u
n
it
y
,”
Nig
e
ria
n
J
o
u
r
n
a
l
o
f
M
e
d
ici
n
e
,
v
o
l/
issu
e
:
1
7
(1
)
,
p
p
.
98
-
1
0
6
,
2
0
1
0
.
[6
]
S.
A
h
m
e
d
,
F.
S
o
b
h
a
n
,
Isla
m
A
.
,
Ba
r
k
a
t
K.
,
“
Ne
o
n
a
tal
M
o
rb
id
it
y
a
n
d
Ca
re
-
s
e
e
k
in
g
Be
h
a
v
io
u
r
in
Ru
ra
l
Ba
n
g
led
e
sh
,”
J
o
u
rn
a
l
o
f
T
r
o
p
ic
a
l
Pa
e
d
i
a
trics
,
v
o
l/
iss
u
e
:
4
7
(2
)
,
p
p
.
98
-
1
0
5
,
2
0
1
1
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8822
I
J
E
R
E
Vo
l.
5
,
No
.
3
,
Sep
tem
b
er
2
0
1
6
:
181
–
1
8
8
188
[7
]
P.
Ka
tu
n
g
,
“
S
o
c
i
o
-
e
c
o
n
o
m
ic
F
a
c
to
rs
Re
sp
o
n
si
b
le
f
o
r
P
o
o
r
Util
iza
ti
o
n
o
f
P
HC
S
e
rv
ice
s
in
Ru
ra
l
Co
m
m
u
n
it
y
in
Nig
e
ria
,”
Ni
g
e
ria
n
J
o
u
rn
a
l
o
f
M
e
d
icin
e
,
v
o
l
/i
ss
u
e
:
1
0
(1
)
,
p
p
.
28
-
29
,
2
0
1
1
.
[8
]
L
.
Am
a
g
h
io
n
y
e
o
d
iw
e
,
“
De
ter
m
in
a
n
ts
o
f
th
e
C
h
o
icr
o
f
He
a
lt
h
Ca
re
in
Nig
e
ria
,”
He
a
lt
h
C
a
re
M
a
n
a
g
e
me
n
t
S
c
ien
c
e
,
v
o
l/
issu
e
:
1
1
(3
)
,
p
p
.
2
1
5
-
2
1
7
,
2
0
0
8
.
[9
]
Ca
m
p
u
s
He
a
lt
h
a
n
d
S
a
f
e
t
y
(C
HS)
,
“
He
a
lt
h
S
e
e
k
in
g
A
tt
it
u
d
e
s
o
f
th
e
Yo
u
n
g
,”
2
0
1
3
.
Re
tri
e
v
e
d
f
ro
m
h
tt
p
:
//
ww
w
.
c
h
s.co
m
o
n
2
7
th
Oc
to
b
e
r,
2
0
1
4
.
[1
0
]
K.
G
o
p
i,
S
h
a
k
e
e
r
K.,
P
.
Ra
v
i,
“
H
e
lp
S
e
e
k
in
g
Be
h
a
v
io
u
r
o
f
A
d
o
les
c
e
n
t
G
irl
s
in
G
o
v
e
rn
m
e
n
t
Ju
n
i
o
r
Co
ll
e
g
e
in
r
u
ra
l
F
ield
P
ra
c
ti
c
e
A
re
a
,”
Ne
w
Yo
rk
,
A
c
a
d
e
m
ic P
re
s
s In
c
o
rp
o
ra
ti
o
n
,
2
0
1
2
.
[1
1
]
Ka
sl
S
.
V.
a
n
d
Co
b
b
S
.
,
“
He
a
lt
h
b
e
h
a
v
io
r,
i
ll
n
e
ss
b
e
h
a
v
io
r,
a
n
d
s
ick
ro
le
b
e
h
a
v
io
u
r
,”
Arc
h
ive
s
o
f
En
v
iro
n
me
n
ta
l
He
a
lt
h
,
v
o
l.
12
,
p
p
.
2
4
6
–
2
6
6
,
2
0
0
2
.
[1
2
]
I.
Ba
n
e
rjee
a
n
d
I.
Bh
a
d
u
ry
,
“
S
e
l
f
-
M
e
d
ica
ti
o
n
P
ra
c
ti
c
e
a
m
o
n
g
Un
d
e
rg
ra
d
u
a
te
S
tu
d
e
n
ts
in
a
T
e
rti
a
r
y
Ca
re
M
e
d
ica
l
Co
ll
e
g
e
,
W
e
st Ben
g
a
l
,”
J
o
u
rn
a
l
o
f
Po
st
g
ra
d
u
a
te M
e
d
icin
e
,
v
o
l/
iss
u
e
:
5
8
(
2
)
,
p
p
.
1
2
7
-
1
3
1
,
2
0
1
2
.
[1
3
]
F.
Ho
o
p
e
r,
K.
M
e
a
k
e
n
,
J.
Jo
n
e
s,
“
He
a
lt
h
S
e
e
k
in
g
B
e
h
a
v
io
u
r
a
n
d
A
tt
it
u
d
e
to
S
e
lf
-
Ca
re
a
m
o
n
g
S
t
u
d
e
n
ts
in
L
o
n
d
o
n
M
e
d
ica
l
S
c
h
o
o
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